Rising Teenage Pregnancy – A National Disaster

They are young, innocent and ill-informed about sexual and reproductive health (SRH) issues especially about how to avoid early pregnancy. These are the 15-19 year-old girls in Tanzania, 27 percent of who are either mothers or expecting their first child.

Sadly, the number has risen (from 23% in 2010), and has generally stagnated: between 25% in 1999 and 27% 2015. This means 27 out of every 100 girls in this age group risk becoming mothers, and subjected to a cycle of poverty, helplessness and dependency.

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This predicament is by no means accidental; it is an outcome of inertia in policy implementation across sectors and administrative structures; cultural insensitivity to adolescents’ SRH needs, and low political commitment to take bold steps to save adolescents lives. In many ways, neglecting this growing challenge denies the country of a potential work force that would otherwise, acquire high level education, and skills, to effectively contribute to socio-economic development.

A 2016 study Global Youth Family Planning Index by the Population Reference Bureau (PRB) that measured the favorability of current national policy and program environments for youth uptake of contraception, ranked Tanzania high among the four countries studied (Kenya, Nigeria, and DRC). Yet, with respect to teenage pregnancy rate, Tanzania is second to DRC whose policy indicators leave a lot to be desired.

Why should this situation be allowed to prevail when 2015-16 Tanzania Demographic and Health Survey and Malaria Indicator Survey (THDS-MIS) shows negligible progress in reducing the high fertility of 5.4 children per woman in the reproductive age, and increasing the contraceptive prevalence rate now at 34% (modern methods) – critical ingredients to lowering the rapid population growth of 2.7% per annum.

If left unchecked, the high teenage pregnancy trend would certainly compound poverty and dependency now is at 9:1 given its demographic profile whereby 65% of its population is under 25 years. Under these circumstances, Tanzania, whose population is project at 80 million by 2030, is unlikely to harness its demographic dividend.

Therefore, more investments and serious attention is needed to reverse the trend if the country is determined to attain a middle-income economy status by 2025; hence a national campaign to address teenage pregnancy is justified; and enhanced adolescent SRH knowledge and access to services should be the campaign’s driving force!

 

Tanzania Advocates Call for Higher Family Planning Allocation

Budget trend for family planning

As members of parliament get ready for the 2017/18 budget session, advocates for family planning are pleading for a higher allocation for family planning. While commending the government for recently announcing a 7bn Tanzanian shillings (Tshs) allocation of FP in 2017/18, representing a 2bn Tshs rise from the current financial year, some members of the Tanzania Coalition for Demographic Awareness and Action (TCDAA) appealed for more given the dwindling donor support.

“With the US government, a major donor in RMNCAH programs worldwide, cutting its funding to UNFPA, a key global actor, family planning programs will more likely be negatively impacted,” a TCDAA member said. This would be felt in the area of commodity supply, as well as capacity strengthening initiatives that have steadily contributed to increased number of family planning providers.

Although Tanzania is making progress in infant, child and under-5 mortality according to the 2015-16 Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS), the indicators for maternal mortality and teenage pregnancy have worsened over time. A comparison of the indicators from TDHS reports shows below:

Trends in teenage childbearingMMR trend

Evidence abound on the association of family planning and maternal mortality where the latter can be reduced by 44%. Investing in family planning also contributes to reduction of teenage pregnancy rates. Although there has been an encouraging trend (figure below) on the government keeping its FP2020 promise – to increase resources for family planning – the allocated and disbursed amounts over the years fall short of an estimated need of 20 billion Tshs as per the National Family Planning Costed Implementation Plan (NFPCIP) 2010 – 2015.

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Advocates are therefore, calling upon the government to increase 5 billion Tshs every financial year between 2017/18 to 2020/21 with a targeted allocation for the latter estimated at 22 billion Tshs. Conversely, Local Government Authorities also ought to increase their allocations and disbursements to strengthen family planning program reach and provide oversight on sustained contraceptive availability as well as demand generation. These efforts will enhance Tanzania’s resolve to accelerate its attainment of a 45% and 60% targets for contraceptives modern, and all methods, respectively and meet its commitment to reduce maternal mortality to 293/100,000 by 2020.

Advocacy Now More Than Ever: Recommitting to FP2020

From the East to the West Coast of Africa, to far and beyond the Asian continent, family planning advocacy partners converged in Baltimore, one of the oldest cities in the United States. These Advance Family Planning (AFP) project implementers spent the last week of March 2017 to take stock of the work they embarked on a few years back to influence favourable policies and increase investments in family planning programs. Click here to learn about the AFP partners meeting 2017.

The ultimate deliverable that unites all partners across countries is to contribute to the FP2020 goal: reaching new 120 million women and girls with quality voluntary family planning information, services and supplies. Therefore, one week of collective reflection annually, is what AFP does to acknowledge advocacy quick wins, determine new approaches while learning from lessons to enrich the project’s interventions across the ten focus countries and a number of partners.

Joined by their main funder, the Gates Foundation, the community of advocates noted with great concern the current challenges that threaten stability of family planning (FP) programs. These ranged between unpredictable political systems in some partner countries, gloomy economic times, and a fast changing global environment. Evidently, the funding cuts by the new US government – the biggest funder of FP programs.

20170331_215122But given the advocacy wins gathered by all partners across countries that have by and large seen more domestic resources channeled to family planning, and policy barriers being overcome to improve FP access, “advocacy was needed more now than ever before” said AFP’s Principle Investigator Duff Gillespie.

In his upbeat presentation at the beginning of the annual meeting, Duff highlighted possibilities and opportunities for strengthening FP advocacy through sustained engagement of working groups, coalitions and maintaining personal contacts with decision makers to ensure local ownership and sustainability of FP programs.

Going forward, AFP implementers using SMART advocacy are determined more than ever before to take FP advocacy to the next level: building on advocacy wins, strengthen advocacy collaborative by drawing in critical CSO actors in focus countries; maximize use of evidence/data to promote accountability; and enhance tracking and measuring success.